• Tae Nyoung Chung, Sun Wook Kim, Je Sung You, Young Soon Cho, Sung Phil Chung, and Incheol Park.
• Department of Emergency Medicine, Yonsei University College of Medicine, Seodaemun-Gu, Seoul 120-752, Republic of Korea. hendrix74@gmail.com
• Am J Emerg Med. 2012 Jan 1;30(1):226-30.

ObjectivesMetronome guidance is a simple and economical feedback system for guiding cardiopulmonary resuscitation (CPR). However, a recent study showed that metronome guidance reduced the depth of chest compression. The results of previous studies suggest that a higher chest compression rate is associated with a better CPR outcome as compared with a lower chest compression rate, irrespective of metronome use. Based on this finding, we hypothesized that a lower chest compression rate promotes a reduction in chest compression depth in the recent study rather than metronome use itself.MethodsOne minute of chest compression-only CPR was performed following the metronome sound played at 1 of 4 different rates: 80, 100, 120, and 140 ticks/min. Average compression depths (ACDs) and duty cycles were compared using repeated measures analysis of variance, and the values in the absence and presence of metronome guidance were compared.ResultsBoth the ACD and duty cycle increased when the metronome rate increased (P = .017, <.001). Average compression depths for the CPR procedures following the metronome rates of 80 and 100 ticks/min were significantly lower than those for the procedures without metronome guidance.ConclusionsThe ACD and duty cyle for chest compression increase as the metronome rate increases during metronome-guided CPR. A higher rate of chest compression is necessary for metronome-guided CPR to prevent suboptimal quality of chest compression.Copyright © 2012 Elsevier Inc. All rights reserved.

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